Acute Rheumatic Fever: Symptoms, Complications and Diagnosis

This article seeks to explore more on Acute Rheumatic Fever, focusing on the causes, symptoms, and diagnosis, of acute Rheumatic fever. The article will also look at the long-term effects of the disease.

Acute Rheumatic Fever (ARF) is an inflammatory disease that can affect the heart, joints, skin and brain of most children and adolescent groups, mostly between the ages of five and fifteen. The disease is very serious and is a result of delayed complications of untreated or inadequately treated group A streptococcal (GAS) throat infections, typically known as strep throat. Although the disease can be

cured, it remains a significant health concern in low and middle-income countries where access to health and medical care may be limited.

Causes and Risk Factors of Acute Rheumatic Fever:

ARF is a result of post-infectious immune reaction to group A streptococcal bacteria. In other words, it is caused by an abnormal immune response to a bacterial infection, wherein the body’s immune system mistakenly attacks its tissues after fighting the strep infection. The strep infection is an infection that leads to a sore and scratchy throat. Due to the attacks on the tissues, different body parts, including the heart, joints, skin and brain begin to inflame.

Following are factors that increase the risk of developing acute rheumatic fever:

Age: Children and adolescent groups between the ages of five and fifteen are most likely to be affected by this disease.
Recurring Strep Infections: If one has strep throat infections that are either repeated or were left untreated, there is a higher risk of getting ARF.
Genetics: If there had been a family member who had ARF or rheumatic heart disease (RHD) before, there is a higher risk of other family members being affected by the disease.
Socioeconomic Conditions: Poor access to medical and healthcare facilities and overcrowding are also notable factors that contribute to the development of ARF.

Symptoms of Acute Rheumatic Fever:

Symptoms for ARF are likely to appear within 2 to 4 weeks after a strep throat infection and the symptoms vary from individuals. Common symptoms:

Fever

A fever sudden high fever is one of the most common early signs of ARF.

Pain and swelling in the joints

Polyarthritis (arthritis that affects five or more joints at the same time), or pain and inflammation in multiple large joints like the knees and elbows, is another major symptom. This condition is migratory, meaning that it shifts from one joint to another.

Carditis

This inflammation of the heart tissues, in particular; the valves, is yet another major symptom of AFR. The inflammation can cause murmurs, chest pains or shortness of breath.

Chorea

Chorea is also known as Sydenham’s chorea and it involves involuntary, jerky movements of the face, hands, and feet. These jerky movements can be accompanied by emotional instability as well.

Skin Symptoms

Erythema marginatum is a notable pink rash that has a central clearing, and subcutaneous nodules under the skin may develop.

General Tiredness

Weakness, fatigue, and malaise are also symptoms that are common during the acute phase.

If ARF is left untreated, it can result in permanent damage to the heart valves, a condition known as rheumatic heart disease.

Diagnosis of ARF

Diagnosing acute rheumatic fever depends on a combination of clinical evaluation, medical history, and lab tests as well. The following is what could be expected:

History and exam: A patient's medical history will be done and an examination of the patient as well.
Lab Tests: Blood checks may be conducted to check for inflammation and recent group A strep infection, an erythrocyte sedimentation rate (ESR), CPR, WBC count, and blood cultures as well.
Throat or Skin Swabs: These may be used to look for group A strep infection.
Jones Criteria: A clinical diagnosis of ARF is made by using the 2015 revised Jones criteria. It includes clinical, laboratory, electrocardiographic, and echocardiographic findings.

Signs of a preceding group A streptococcal infection is essential for diagnosis and can be confirmed Acute Rheumatic Fever Test (Click to book) or

Through throat cultures,
Rapid antigen tests, or
Elevated streptococcal antibody titers etc.

Complications and Long-term Effects of ARF

Rheumatic heart disease (RHD) is considered one of the most serious complications of ARF, involving permanent damage to the heart valves and can lead to heart failure, arrhythmias, and an increased risk of stroke. Frequent monitoring through echocardiography is important for individuals with a history of ARF.

Conclusion

Acute Rheumatic Fever is a preventable but dangerous condition with lifelong consequences if not attended promptly. Having information regarding its causes, symptoms, and diagnosis is important, especially in communities with high prevalence rates. Immediately consult a healthcare provider if any of its symptoms show up.

Frequently Asked Questions (FAQs)

What is the Acute Rheumatic Fever (ARF)?

Acute Rheumatic Fever (ARF) is an inflammatory condition that occurs due to the body’s overreaction to bacterial infection.

What are the Various signs of Acute Rheumatic Fever?

Different signs of Acute Rheumatic Fever include fever, swelling, carditis, skin symptoms etc.

What are the causes of Acute Rheumatic Fever?

The cause of Acute Rheumatic Fever is an abnormal immune response to the bacterial infection caused by streptococcus A bacteria.

Which tests are used for Acute Rheumatic Fever?

Different tests used for Acute Rheumatic Fever include the ARF test, throat cultures, Rapid antigen tests, Elevated streptococcal antibody titers etc.